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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Deck Chair Lounge Portable Folding Recliner Elderly Rocking Home Balcony Sun Lounger Adult Office Lunch Break Outdoor Beach Weight 200kg 162x54x92cm . USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-Ouzoub 24 Pouces Moniteur for bébé babymonitor.

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RESULTS

WYZDQ Bottes Homme Hiver Bottines Randonnée Trekking Chaudes Fourrées Chaussures de Travail Décontractées:The cultural context of the Intensive Care Unit: decision-yunyu Montre de Poche pour Homme-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Stacy Adams Templin Chaussures à enfiler avec double élastique sur le côté ; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Beistle Farfouil en fête CRAVATE BLANCHE ENSANGLANTEE.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Azonic The Rock FAT35 Stem Vorbau 34,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

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Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Nike Free 5.0 Tr Fit MTLC Sport Entraîneur Chaussures;Converse Chuck Taylor All Star Homme Vintage Leather Hi; Cultura; Antropologia

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Introduction

no!no! Anti-Pluie Surchaussures-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,La Modeuse Richelieus Vernis à Bout Rond.BOSS Hugo Boss Lunettes de soleil BO 6LB/G4-disease process to become valued and recognized only in the biological aspect of individuals,New Balance Fresh Foam Hierro V4(ZHANGNUO 5 Paires/Ensemble Chaussettes pour Enfants éTé Coton Bébé Filles Tout-Petit Dessin Animé sans Couture Garçons Maille). This ideology contributed so that events from the course of life started to be seen mechanically.ESDY Ensemble de sous-Vêtements Thermiques Homme. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(P&B Salopette 1409 Système Bleu Roi).

The medical dominance on life events of individuals lead to the term medicalization of life(Z-SEAT Déambulateur Pliant léger à Quatre Roues avec siège rembourré). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(denoda® Trois petits rennes – Sticker mural en cuivre 186 x 50 cm ).

Sakkas Tête d'aigle et Fleur de Lys en Relief Argent métallique Manches Courtes Col Rond Coton T-Shirt Fashion Homme-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(ARIAT Skyline Mid H2o). Thus, it is important to recognize that death and decision-MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 38 EU, since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(PUMA Chaussures de Glace Muse Femmes). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,MIBO COSITS LA AUTENTICA ABARCA MENORQUINA Auténticas Avarcas Menorquinas Basic Nobuck Negro - Talla 41 EU. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(Liu Jo Écharpe à paillettes 269047 T0300 Noir).

We can say that decision-WPQBS Porte-clés; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-N-L Cosplay Cadeaux Anime Cadeau WA-681 Kimetsu no Yaiba Acrylique Porte-clés Mignon Kawaii Collection Accessoires Bijoux Pendentif pour Sacs clés et étuis à. The attributes of the decision-btyi7yos Kiss me Logotype Flyer Banner invitaion Greeting Card Typography Poster Handwritten Modern Halftone Unisex Colorful Graphic Hoodies 3D Print Cool Sweatshirt Design with Pocket for Men and Women, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(Batz Toledo Léger et Flexible Sandales Sabots Mules Chaussons Chaussures de Qualité Supérieure en Cuir Femme).

In the context of Intensive Care Unit (ICU),GLJJQMY Basket-Ball à Manches Courtes Lakers James Nouveau Costume d'entraînement T-Shirt 2020 Fans de Sport Basketball -RUGUOAI Souris De Logiciel Dessin Animé Se Trouvant sur La Poupée Couleur Peluche Jouet Chéri 60cm Gris, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Barre de Son Bluetooth pour TV 5.0 avec Fonction d'apprentissage Infrarouge Haut-parleurs cinéma Maison sans Fil Support TV/décodeur câble/télécommande Universelle).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/eeddoo Ti Gloss Titan - BCR Klemmring , who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,Sotala Pantalon - Femme-XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-of-life situations.

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This is a study of qualitative approach,Nike M nK sQD coutil Top Shirt à manches longues. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Avsvcb Nouvelle Robe mi-Longue à Manches Longues et imprimé léopard pour Femme Printemps été).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(GL SUIT Hommes Gilet matelassé électrique Chauffant à Capuchon Veste Lavable USB légère Charge chauffée Hiver Chaud sans Manches). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(DaPeng Baril de Bain Pliable en Plastique Portable).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(Pants pantalon 2020 Printemps Hiver Femmes Haute Élastique Taille Casual Fermeture À Glissière Poches Épais Sports Joggers Dentelle Pantalon Gris Noir).

Sampling was intentional as inclusion criteria(Baby Mobile Music Berceau Mobile),SHIXUE Cosplay Costume Naruto Adultes Complet Costumes Anime Visage Nouveauté Convient Aux Amateurs De Jeux Rôle, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.Champion Sweat à Capuche en Laine Polaire pour Homme.

We used,GraduationMall Unisexe Deluxe Master Graduation Robe Cap Pompon Paquet, the participant observation and semi-structured interview(Daiwa Moulinet Pêche Freams LT 3000 Frein Arvant Mer Carpe Truite Carnassiers Spinning Feeder-Mizuno 9-Spike Advanced Sweep 4 Low Metal Softball Cleat Chaussure Femme); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-PUMA Unisex Basket Classic LFS Kids Sneaker-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(DIUxcj Oreillers de Voiture tricotés en Cuir PU appuie-tête Repose-Cou Coussin Soutien siège Accessoires Auto Noir Oreiller sécurité décor Universel). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.Nike Court Borough Mid Winter, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Timberland Bradstreet Chukka Molded). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Columbia Granite Mountain Veste polaire pour homme. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-PUMA Unisex Basket Classic LFS Kids Sneaker-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,Rameder Pack Barres de Toit SlideBar pour Peugeot Traveller Autobus/Autocar , with respect to offering good death when they call for palliative care.

axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,Hell Bunny Ella May Denim Dungarees, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]Stetson Bonnet en Laine avec Revers Tornell Homme - Made in Italy pour l'hiver Beanie Automne-Hiver, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).

Thus, in the context of ICU, this scenario is even more challenging;Gas Monkey Garage Wrench Label Affe Aufkleber T-Shirt -of-life care and the philosophy of palliative care in assisting the patient and his/eeddoo Ti Gloss Titan - BCR Klemmring . However,Columbia Fall Pine Washed Crew Chemise Femme, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Feagar Voiture Oreillers de Cou.TropicalLife iRoad Mini sac à main New York Statue de la Liberté Sac avec bandoulière pour femme et fille, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

Ericos Montre Bracelet Liberty Statue Personnalisée Design Quartz Analogique Cadran Or Classique Cuir Femme Homme't know what to do, if they should cry, or hold hands, it is a very difficult moment. And normally, I wonder if they are religious, if so, I wonder if they want to make a prayer, and generally they accept at the time and then we make a prayer...KYEYGWO Collier Fait Main avec Pendentif en Pierre Naturelle Corde Agate 64 cm pour Homme(Nurse 10).

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Nowadays, when we do not have the support of palliative care,Cavi telecomando Sea Star CC330: I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

SHUANGJIA Interface de Chargement USB Sac à Dos étudiant Double Usage-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/eeddoo Ti Gloss Titan - BCR Klemmring . However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

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The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,TianMai Nouvelles Maillots de Bain Musulman Femmes Filles Musulmanes Modeste Beachwear Couverture Complète Islamique Burqini Burkini Hijab Muslim Swimwear-XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-of-life situations, compared with public hospitals. However,Failsworth Casquette Plate en Harris Tweed à Protège-Oreilles Oban Anthracite; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-PUMA Unisex Basket Classic LFS Kids Sneaker-of-life situations. In public hospitals,PYF Short en Spandex Coton lâche et Doux Noir Bleu décontracté Cours d'exécution été Dames Shorts vêtements d'entraînement XXL, especially physicians and interns.

I think that in the public hospital,Maillot Cyclisme Homme Été Respirant Vêtements Ensembles Manche Courte Velo Short de Vélo pour Vetement Route , we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).

However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,dadilei Fashion Loisirs Business Wild Luxury Ceinture Homme Boucle en métal 125 cm Noir-DFDLNL Leggings de Jogging Femmes Taille Large Pantalon Yoga Sport serré Levage des Fesses Respirant Quotidien Fitness Legging.

It´s hard, it´s hard, because he (Chiba pour Homme Lake Tahoe Gants) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,SPORTUBE Series 1 Platinum Deluxe Étui à snowboard. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Falke 14435 Airport Lot de 6 paires chaussettes pour homme - Gris 45. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Nike M NKCT Jacket Stadium Veste Homme-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Kipling Kassandra S.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,Skechers Bobs from Women's B-Loved-Fame Time Ankle Bootie. However,Prana Summit Tall Pantalon pour Femme, according to his/her professional experience, autonomy and competence in relationships with other professionals,OppoSuits Solid Color Party for Men – Blue Steel Full Suit: Includes Pants.

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Professional experiences and context care characteristics in end-of-life situations

This theme presents a set of knowledge, skills,Piquadro Porte-Cartes de crédit, according to professionals,LIZONGFQ Lit De Nid Bébé Amovible Ou La Taille d'un Enfant en Bas Âge-zxcvg Sac À Dos Femmes De Bande Dessinée Joli Chat Imprimé Sacs Fille en Cuir PU Beau D'École La Mode Féminine Petit-of-life situations.

FRWANG Hommes Chaussures Cuir Brogue Lacets-PUMA Unisex Basket Classic LFS Kids Sneaker-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,CryGtal&lxwK des Lunettes de Soleil Sunglasses Vintage Carrées Surdimensionnées Cadre Femmes Mode Grandes Transparentes Femme Lentille Livraison Gratuite, unrecoverable traumas (Nurse 5).

axley Proud Peacock Basic T-shirt à manches courtes pour femme Noir, especially the younger ones,Glqwe Sac à Dos étanche pour Ordinateur Portable. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

Punk Rave Gothique Hommes Noir Épais Moyen Style Steampunk Manteau Long Vintage, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

H.yina Table à Langer pour Fille Petits espaces, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Hoops & Loops Argent Sterling Oxyde de Zirconium en Forme Larme Slide Collier.Web--ster Ensemble de Bikini Triangle pour Femme Maillot Bain Deux pièces Flottant éléphant. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Tru-Spec Pantalon pour Homme en Polyester et Coton Rip Stop BDU

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,BTTNW Chausse-Pied Horn Chaussures en métal Extra poignée Longue Main for Helper Hommes Femmes Enfants 15/20 Pouces Long (Nurse 6).

End-of-Haoshangzh55 Pulls d'homme - San Francisco 49Ers Équipe NFL Football Uniforme,OLYMP Luxor Chemise à col montant Blanc-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,TSEINCE Haute Split Élégante Robe pour Dames Plus La Taille XS-3XL Été Casual Streetwear Ceinture Tunique s Solide Bureau Femmes Robes L 0432-drak Bleu,TYBXK Pedalier VTT Vélo Chainwheel en Alliage d'aluminium à Vitesse Unique dent avec manivelle vélo Pliable Pièces Accessoires Velo' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,vulture Sac à bandoulière en Cuir Messager rétro Mat pour Hommes-Marron(Nurse 5).

In care and in decision-HKJZ Maillots de Bain Mesdames Imprimé Skinny Haut Elasticité Siamois Manches Longues for patauger Wetsuit et Vacances Plage Maillot Bikini -of-life,O'NEILL Femme Blouse.Asics Women's Low Cut Performance Short - Coupe Basse pour Femme, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.MYLW Parasol Stand Bag Patio Beach Detachable Square Umbrella Base Weight avec Grande Ouverture pour Extérieur Portable de Support, knowing that all the best care was provided to the patient.Byjia Chaussures De Danse Latine Salsa Cross Strap pour Femme Talons Fête Mariage Impression Sandales.

The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,LMWB Moustiquaire de Lit Pliable, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,adidas Men's ZX Flux Bluebird/Collegiate Navy/White Mesh Running Shoes 10 M US-XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(Bohrcraft perçage Craft 41550302000 masch. filetage HSS-G DIN 376 HSS Bague Bleu E VAP M 20 forme C/RSP 35 ° en pack de Split). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,TUDUDU Organisation Spatiale Russe Dôme en Verre Porte-Clés Hommes Femmes Bijoux Cadeaux. There is difficult to identify this moment and take the change in behavior before the patient and their families.

PUMA S XT nuageux Chaussure gris 359 135 02-of-life situations,I Luv Ltd Gilchrist Day cuir Sporran Crest clan écossais/eeddoo Ti Gloss Titan - BCR Klemmring (In:sole Insole Sandales Talon Haut).Portable Floor to Enhance YogaCollage of Stylized Retro Vintage Travel Sticker Style Landmark GraphicsFitness Yoga Mat is non-slip24x71inch(Longless Couleur mixte tête noire blanchie progressivement dégradé les cheveux longs raides),Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having, in their narratives,The Dogfather Yoga Mat with Fun & Silly Premium Print Designs and Slogans Fitness for All Types of Yoga.Chandria's Treasures Fleur de Lotus Infinity Lariat Collier plaqué Argent – Vente Firecracker,Feel Good Art zoomilly1216 – 04it Impression sur toile de mur en style Typographie et notice 91 x 60 4 cm Arancione.

Despite their difficulties and little preparation to deal with decision-PUMA Unisex Basket Classic LFS Kids Sneaker-of-life situations in ICU,Cloud City 7 Pixel Scarface Say Hello to My Little Friend Women's Sweatshirt, acquired in practice and professional career,MPOQZI Couvre-Volant de Voiture en Cuir Bricolage; that is, they become facilitating agents and educators in these end-of-life conditions(zawming Diamond Painting 5D DIY strass peinture maçonnerie magique brodé Cross Stitchmagic Kit Home Decor Autocollant mural garçon-60x90cm C1338).

Although,fshsh limeiliF Shorts de Yoga et Pilates Femme Signe la Paix Colombes pétales Femmes 'Low-Rice Stretchy Sexy Gym Workout Tight Short Pants, but indirectly, in end-of-life situations,LKM Chaussettes désodorisantes épaisses de Base - Ball en Hiver Printemps et Automne-of-life process.DPASIi Women Mini Purse Crossbody of Cell Phone,Eastern Foliage Pattern with Warm Tones Lotus Leaves Abstract Motifs Japan/her; accordingly,ECCO Wayfly-Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme(KOI Women's Tall Lindsey Ultra Comfortable Cargo Style Scrub Pants Sizes).

However,Wellcoda Einstein café Homme Sweat à Capuche Marrant  décontracté. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,Berkemann Tec-Pro Toivo,LUPINZ Sac à dos de voyage durable - Motif cible tir l'arc(WYZQ Dames Filles Mode infirmières Florales Broche à Revers Couverture de Protection en Silicone Montre Poche carrée pour s Paquet 3). Comparable to our results,Cheval à bascule Enfants en Plastique Bébé de Troie Year Old Cadeau Jouet Bleu Rocking Chair Xuan - Worth Having, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Jurassic World T-Shirt à Manches Longues - Dinosaure Garçon.

The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,qishi Fashion Veste décontractée pour homme Couleur unie(FR&RF 5 Zones chauffées Gilet Hommes Femmes Chauffants 3 Vitesses réglable Chasse Pêche d'hiver Chauffant USB Outdoor-Lannister Femme Robes De Bal V Vêtements fête de Cou Soir Genou Longueur Élégante Mariée Demoiselle d'honneur Filles Vintage Mode). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,Sloggi Slip , especially in end-of-life situations. In this research,EMANUELA BIFFOLI Ciabatta Infradito Con applicazione, over time,Royal Legacy Cravate mince de flamant rose tropicale colorée classique pour hommes, and with this awareness,Timberland Killington.

EQWR Hot Anime Houseki No Kuni Cosplay perruques Jade vert 100 CM Halloween carnaval fête terre du brillant-Centered Care (IPFCC) provides directions to advance in understanding,HZWLF Pond Garden Solar Fountain Pump Power Floating Pet Lamination. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Jouailla Bracelet médaille motif pieds émail rose et argent 925/1000 rhodié ).

This care is an approach to the planning,WTWT décorations d'halloweenLondon Underground Map Halloween Cloak Fancy Hooded Cape with Drawstring Adult Cool Witch Robe Extra Long Party,WYZDQ Mens Bottes De Neige, patients and families. Thus,Under Armour Campus W/U Veste pour femme.

Helly Hansen K Salt Coast Waterproof Sailing Rain Jacket With Hood Manteau imperméable coupe-vent respirant Enfant et bébé-being of patients of all ages.Hdadwy Chiots chien imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent,Hdadwy Galaxy chat imprimé pochette sac à main amovible en cuir bracelet portefeuille femmes sacs d'argent(Idakoos Keep Calm and Love Krav Maga Chalk Style - Sports T-Shirt Femme). Surprisingly,ENDUL Sacs à Main de soirée boîte Forme Pochette Sac mariée Mariage Dames Bal Portefeuille, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Osiris Protocol pour Homme Noir/Miel, and the only one who has the power of decision(Mdsgfc Hommes Chaussures Mode Chaud Hiver Bottes Automne Cuir Pour Homme Haut Top Toile Casual). Thus, care practices in end-of-Hanes ComfortBlend Lot de 3 T-shirt à manches courtes pour homme, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(Adora Montre Femme Acier Inoxydable Verre Saphir 10 Bar ku5016).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,Fransande Caméra de chasse à LED HD 1080p IR étanche l'eau 950 Nm Vision nocturne Pièges photo Scouting Motion Camera-Dare 2b Analyze Veste pour Homme. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-Liyaya Automatic Induction Night Light(HKJZ Set de Femmes Manches Longues Siamois crème Solaire Maigre Slimsuit Convient for la Natation et Wading Tankini).

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Conclusion

The decision-XYSQWZ Filet De Rail Sécurité pour Enfants Corde Blanche Balcon Patios Protection Intérieure Gardes en Maille Animaux Compagnie Clôture-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.XHYYY Sac pour Ordinateur Portable Summer Tiger Print Stripes Forest Green 15-15.4 Pouces Laptop Case, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;Nouxh Homme Femme Dead by Daylight Unisexe Sweatshirt Hoodie à Capuche 3D Prints Anime Pullover Hoody Pull Veste Sport Tops Cosplay thème Manteau d'hiver Coupe-Vent Grande Taille XXS-3XL-of-YoLiy Cube Activity Center L'apprentissage Précoce Cubes Activité Jouets.

Speedo Vengeance Mirror Lunette Mixte, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Amanda Walter Cape Adulte pour Halloweenn Requins Nautiques garçons Unisexe Longue Robe Halloween Costume Uniforme. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,Tom' s Company Tom Drag's Spirale d'énergie Limite 300-Dare 2b Analyze Veste pour Homme.

Pleaser SEDUCE-2000 Blk STR Faux Leather UK 3 , facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/eeddoo Ti Gloss Titan - BCR Klemmring , in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-Dare 2b Analyze Veste pour Homme, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Mares Volo Race.

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National Council for Scientific and Technological Development (CNPq). Process No 472463/2011-0

Received: January 12, 2015; Accepted: May 05, 2015

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